Nursing Diagnosis for Schizophrenia: 6 Nursing Care Plans

Your job with a schizophrenic client comes down to safety, trust, and reality. Hallucinations and delusions can drive a client to hurt themselves or someone else, so you assess risk first, build rapport second, and reinforce what is real throughout. This guide walks the assessment, diagnoses, goals, and interventions you will actually use on the unit.

What is Schizophrenia?

Schizophrenia is a group of severe, disabling psychiatric disorders marked by withdrawal from reality, illogical thinking, delusions and hallucinations, and emotional, behavioral, or intellectual disturbance. Symptoms split into positive symptoms (hallucinations, delusions, formal thought disorders) and negative symptoms (anhedonia, poverty of speech, lack of motivation).

The diagnosis is clinical, made after a full psychiatric history and after ruling out other causes of psychosis. Early warning signs usually surface in adolescence: depression, social withdrawal, poor concentration, hostility or suspiciousness, flat emotional expression, insomnia, neglected hygiene, or odd beliefs.

Under the DSM-5, 2 or more of the following must be present for a significant portion of a 1-month period:

• Delusions
• Hallucinations
• Disorganized speech
• Grossly disorganized or catatonic behavior
• Negative symptoms

Risk factors fall into two groups:

• Genetic. Risk is elevated in biological relatives but not adopted relatives. In first-degree relatives the risk is 10%. If both parents have schizophrenia, the child's risk is 40%.
• Perinatal. Maternal malnutrition or certain viral illnesses during pregnancy, obstetric complications, and winter birth are all associated with higher risk.

The APA removed schizophrenia subtypes from the DSM-5 because they did not help target treatment or predict response.

Nursing Care Plans and Management

Management means recognizing the disorder, assessing positive and negative symptoms, establishing trust, reducing symptoms, improving communication and social functioning, building coping strategies, promoting medication adherence, and evaluating the support system.

Nursing Problem Priorities

• Establish therapeutic rapport and trust
• Monitor and manage symptoms
• Administer antipsychotic medications
• Provide education and support
• Assist with daily living skills
• Collaborate with the interdisciplinary team
• Ensure a safe environment

Nursing Assessment

Assess for these subjective and objective findings:

• Positive symptoms:
  • Delusions, persistent false beliefs
  • Hallucinations, sensory experiences without external stimuli
  • Disorganized thinking, incoherent or illogical thought processes
  • Abnormal motor behavior, unusual or unpredictable movements
• Negative symptoms:
  • Reduced emotional expression
  • Social withdrawal
  • Lack of motivation
  • Impaired cognition (attention, memory, problem-solving)

Nursing Diagnosis

After assessment, you formulate a nursing diagnosis based on clinical judgment and the client's unique presentation. Diagnostic labels organize care, but in practice your judgment about the client's priorities matters more than the label itself.

Nursing Goals

Goals and expected outcomes may include:

• The client expresses thoughts and feelings in a coherent, logical, goal-directed manner.
• The client demonstrates reality-based thought processes in verbal communication.
• The client spends time with one or two other people on structured, neutral-topic activity.
• The client spends two to three 5-minute sessions with the nurse sharing observations about the environment within 3 days.
• The client communicates in a way others can understand, aided by medication and attentive listening, by discharge.
• The client learns one or two diversionary tactics to decrease anxiety and think more clearly.
• The client maintains interaction with another client during an activity such as a board game or drawing.
• The client engages in one or two activities with minimal encouragement.
• The client states comfort in at least 3 structured, goal-directed activities.
• The client learns ways to refrain from responding to hallucinations.
• The client states that the voices are no longer threatening and no longer interfere with life.
• Using a scale of 1 to 10, the client reports the voices are less frequent and less threatening with medication and intervention.
• The client identifies personal interventions that lower the intensity or frequency of hallucinations (music, headphones, reading aloud, jogging, socializing).
• The client demonstrates techniques that distract from the voices.
• The client remains free from injury, with no wounds or abrasions.
• The client develops trust in at least one staff member within 1 week.
• The client sustains attention and concentration to complete tasks.
• The client reports that intrusive thoughts are less intense and less frequent with medication and intervention.
• The client talks about concrete happenings for 5 minutes without referencing delusions.
• The client demonstrates two effective coping skills that minimize delusional thoughts.
• The client functions without responding to persistent delusional thoughts.
• The client removes themselves from situations as anxiety rises, aided by medication and intervention.
• The client demonstrates decreased suspicious behavior during interactions.
• The client applies stress and anxiety-reducing techniques independently.
• The client states feeling safe and more in control during interactions at home, work, and social settings.
• The family or significant others describe the early signs of relapse and know whom to contact.
• The family or significant others receive written information on relapse signs and contacts before discharge.
• The family or significant others access community and agency resources for education, support, coping skills, and social network development.
• The family or significant others state what medications do, their side effects and toxic effects, and the need for adherence at least 2 to 3 days before discharge.
• The family or significant others hold a complete list of community supports at least 2 days before discharge.
• The family or significant others attend at least one family support group within 4 days of the acute episode onset.
• The family or significant others meet with the nurse, physician, or social worker on day one of hospitalization to begin learning about the disease, treatment, and resources.
• The family or significant others problem-solve two concrete family situations with the nurse.
• The family or significant others demonstrate problem-solving skills for tensions and misunderstandings within the family.
• The family or significant others have access to family and multifamily support groups and psychoeducational training.

Nursing Interventions and Actions

1. Promoting Client Safety

Hallucinations and delusions can drive injury, and these clients also carry a real risk of substance abuse and violence. Safety is your first move.

Watch for rising fear, anxiety, or agitation. This can signal hallucinatory activity, and a client may act on command hallucinations to harm self or others.

Explore how the client experiences the hallucinations. Sharing the experience gives the client a sense that the commanding voices can be managed.

Assess for substance abuse. Alcohol and drug use are common, sometimes used for relief from symptoms or medication side effects, and strong enough to drive even disorganized clients to find substances.

Watch for obsessive-compulsive symptoms. Checking, counting, or repeating behaviors occur in many clients and are a known adverse effect of some antipsychotics, particularly clozapine.

Help the client identify the needs underlying the hallucination. Hallucinations may reflect needs around anger, power, self-esteem, or sexuality. Many clients keep their problems to themselves because they fear burdening family.

Accept that the voices are real to the client, but state plainly that you do not hear them. Refer to "your voices" or "the voices you hear." Do not argue with hallucinations or delusions, and do not try to correct the distorted reality. Acknowledge that you each perceive the world differently.

Help the client identify when hallucinations are most prevalent and frightening. This pinpoints the situations and times that are most anxiety-producing. Command hallucinations can be self-deprecating enough to drive a suicide attempt.

• If voices tell the client to harm self or others, take environmental precautions.
• Notify others, police, physician, and administration per unit protocol.
• In the hospital, follow protocols for suicide or threats of violence if the client plans to act on commands.
• In the community, evaluate the need for hospitalization.

Swift, decisive intervention can prevent suicide or harm to others, so recognizing the risk and acting on it is critical.

Document what the client says. If the client is a threat to others, document who was contacted and notified per agency protocol. Suicidal ideation is strongly linked to completed suicide, so if ideation is present, ask directly about a plan.

Stay with the client at the start of a hallucination and direct them to tell the voices to go away. Repeat it matter-of-factly. Within a trusting relationship the client can learn to push the voices aside. Do not leave the client alone, and involve family or friends to stay with them while treatment is arranged.

Decrease environmental stimuli. Low noise and minimal activity reduce the anxiety that can trigger hallucinations and help calm the client.

Intervene early with one-on-one contact, seclusion, or PRN medication as ordered. Step in before anxiety escalates. If the client is out of control, use chemical or physical restraints per protocol. The acutely suicidal client needs a secure, highly supervised setting, and inpatient care is one of the best options.

Keep conversation simple, basic, and reality-based. Help the client focus on one idea at a time. Disorganized thinking and thought blocking make this necessary, and reinforcing reality is part of the work.

Find activities that reduce anxiety and distract from hallucinatory material, and practice them with the client. Vocational and art therapy can build self-esteem and improve functioning.

Engage the client in reality-based activities such as cards, writing, drawing, simple crafts, or music, kept within their functioning level. Keeping the client focused on the here and now helps them cope.

Administer clozapine as indicated. See Pharmacologic Management.

Refer clients with substance abuse to a dual-diagnosis treatment program. These programs integrate mental health and chemical dependency care and produce better outcomes.

Remove all dangerous objects from the client's room. Ask for any weapon, knives, or pills and secure them. Removing ligature points significantly reduces inpatient suicide, including death by hanging.

Prepare the client for cognitive behavioral therapy (CBT). In active-duty military personnel who attempted suicide or had ideation, brief CBT cut followup suicide attempts: treated soldiers were approximately 60% less likely to attempt suicide than untreated soldiers.

2. Establishing Therapeutic Relationships and Promoting Therapeutic Communication

Build a safe, nonjudgmental space where the client can express themselves. Active listening, empathy, clear and simple language, and time to process all support trust and effective communication.

Assess whether incoherent speech is chronic or a sudden exacerbation. A baseline lets you set realistic goals. Communication impairment is reliably measurable and is elevated even in first-degree relatives.

Identify how long the client has been on antipsychotic medication. Therapeutic levels support clear thinking. The client may calm almost immediately, but the psychosis itself takes several weeks to lift.

Measure communication impairment with the Communication Disturbances Index (CDI). The CDI rates speech on unclear references and grammatical disturbances that fail to communicate the intended message.

Look for themes even when the words are incoherent (fear, sadness, guilt). Word choice is often symbolic. Speech may be circumstantial (long, wordy answers) or tangential (talks at length but never answers).

Keep your voice low and speak slowly. A loud, high-pitched tone raises anxiety; slow speech aids understanding.

Keep the environment calm, quiet, and low-stimulus. This keeps anxiety, confusion, and hallucinations from escalating.

Plan short, frequent contacts throughout the day. Short periods are less stressful and build familiarity and safety.

Use clear, simple words and simple directions. The client may struggle to process even simple sentences and may show thought blocking.

Use concrete, literal explanations. Abstract phrasing gets misunderstood or folded into the delusional system. These clients struggle with abstract thinking and proverbs.

Direct the client's attention to concrete things in the environment. This pulls focus away from delusions. Do not try to correct psychotic thinking or reinforce distorted reality. Position yourself as support.

When you do not understand the client, say so. Pretending to understand costs you credibility and trust. Do not argue with hallucinations or delusions, and stay engaged without judgment.

When the client is ready, teach strategies to lower anxiety and quiet the voices:

• Focus on meaningful activities.
• Replace negative thoughts with constructive ones.
• Replace irrational thoughts with rational statements.
• Practice deep breathing.
• Read aloud to self.
• Seek support from staff, family, or other supportive people.
• Use calming visualization or listen to music.

Lowering anxiety enhances functional speech. Distorted negative thinking can trigger anxiety, depression, or suicidal urges, which you want to head off.

Use therapeutic techniques to clarify feelings when speech is disorganized. Get to the feeling behind the words. When the client feels valued and accepted, the emotional burden can ease.

Establish rapport and build trust. Trust drives effective communication at every phase and makes the relationship smoother as problems come up.

Give positive feedback and genuine appreciation. Praise for positive behavior is valued more than goods and helps the client feel cared for.

Confirm the medication has reached therapeutic levels. Many positive symptoms subside with medication, easing interaction. Long-acting injectable risperidone outperformed oral risperidone on relapse, symptom control, and control of hallucinations and delusions.

Identify the symptoms the client feels when anxious around others. Rising anxiety intensifies agitation, aggression, and suspiciousness. Anxiety can precede onset by years.

Keep the environment free of loud noise and crowding. Crowding and noise can trigger agitation and impair concentration. A calm, structured environment improves outcomes.

Avoid touching the client. An unknown person's touch can be misread as sexual or threatening, especially for a paranoid client. Social cue recognition is impaired in schizophrenia.

Set realistic goals, in the hospital or community. Unrealistic goals frustrate the client and set up mutual withdrawal. Small wins build confidence and motivation.

Structure activities at the client's pace. Overly ambitious activities lose the client and deepen a sense of failure.

Build in planned, brief one-on-one interactions each day. This develops safety in a nonthreatening setting. Social motivation problems vary: some clients lack drive to seek interaction, others want connection but avoid it out of fear of rejection.

When the client cannot respond coherently, spend frequent short periods with them. A quiet, interested presence counters the social isolation these clients face.

For a very paranoid client, choose solitary or one-on-one activities that take concentration. Concentration minimizes distressing paranoid thoughts and voices.

For a delusional or hallucinating client who cannot concentrate, offer very simple concrete activities such as looking at a picture or painting. Simple activities pull the client toward reality. Coloring or drawing can improve concentration and reduce stress.

For a very withdrawn client, start with one-on-one activity with a safe person. Once safe with one person, the client may join a structured group.

Build on the client's prior strengths and interests. This raises participation, enjoyment, and satisfaction with therapy.

Teach the client to step away when agitated and use anxiety relief exercises (meditation, rhythmic exercise, deep breathing, progressive muscle relaxation). Regular practice builds the skill and a sense of control.

Teach conversational and assertiveness skills. These are fundamental coping skills, and constructive problem-solving helps the client understand and work through problems.

Acknowledge positive steps in social skills. Recognition sustains and increases the behavior and helps the client feel valued.

Provide social skills training in a nonthreatening setting. Start with basics: appropriate distance, good eye contact, calm manner, moderate voice tone. Social cognition is a building block for interpersonal interaction and productive activity.

Grade activities to the client's tolerance, for example (1) a simple game with one safe person, then (2) slowly add a third person. Gradual exposure builds safety and competence. Socialization group therapy helps clients introduce themselves, get acquainted, converse, and discuss topics within a group.

Make coping skills training available as the client progresses:

• Define the skill to be learned.
• Model the skill.
• Rehearse it in a safe environment, then in the community.
• Give corrective feedback.

Coping skills training improves mental and physical health, raises self-esteem and group interaction, and lowers depression and isolation.

Eventually bring in other clients and significant others for card games, ping pong, group sharing, and similar at the client's level. Family responses shape the illness trajectory, and family interventions can prevent relapse, reduce admissions, and improve adherence.

Prepare the client for cognitive remediation. Built on neuropsychological rehabilitation and brain plasticity, it improves numerous cognitive functions and works best when the client is stable.

Refer the client to vocational rehabilitation. Most clients want to work, and employment improves income, self-esteem, and social status. Supported employment with individualized, rapid job placement integrated with other services produces higher employment rates.

3. Improving Thought Organization and Reality Orientation

Help the client organize thoughts and think logically, and gently orient them to time, place, and situation so they can separate what is real from what their illness distorts.

Identify the feelings behind delusions. For example:

• Belief that someone will harm them signals fear.
• Belief that someone controls their thoughts signals helplessness.

Feeling understood can lessen anxiety. Asking whether the client hears voices is an early intervention, and any hallucination must be reported immediately.

Understand what the belief means to the client at the moment. Seemingly illogical fantasies hold clues to underlying fears. Clients can feel that their own thoughts are alien and outside their control.

Treat delusions as the client's perception of the environment. Do not pretend to see or hear hallucinations, do not agree with delusions, and do not try to argue the client out of them. State, "I know the voices are real to you, but I do not hear them," which is honest and helps the client gain control over the thoughts.

Assess attention span, distractibility, and anxiety level. A short attention span both causes and feeds anxiety. Offer empathy: "You seem anxious. How can I help you?"

Explain procedures and confirm the client understands before you start. Full knowledge of procedures reduces the sense of being tricked. Memory difficulty means you may need to repeat steps or phrases.

Distract from delusions with reality-based activities such as card games or simple crafts. Use one-on-one activities for a suspicious client. Time spent on reality-based activity is time free of delusional thinking.

Do not touch the client, and use gestures carefully. Suspicious clients may read touch as aggressive or sexual. Face the client, hold eye contact, stay near but not too close, position at their level, show interest or concern, and speak slowly and calmly.

Do not argue with the client's beliefs early on. Arguing strengthens the defensive position and reinforces the false belief, leaving the client more isolated. You can ask about the delusion for assessment, but do not deny it.

• Encourage healthy habits to optimize functioning:
• Maintain the medication regimen.
• Maintain regular sleep patterns.
• Maintain self-care.
• Reduce alcohol and drug intake.

These keep the client in remission. Adherence is usually overestimated, even partial nonadherence drives relapse, and because many psychotropics cause weight gain and metabolic changes, keep the client as physically active as possible.

Show empathy and reassure the client of your presence and acceptance. Delusions are distressing, and empathy conveys caring and acceptance while placing the work of understanding on you, not the client.

Teach coping skills that quiet worrying thoughts:

• Go to the gym.
• Phone a helpline.
• Sing or listen to a song.
• Talk to a trusted friend.

Teach strategies the client can use alone when ready. Clients with schizophrenia tend to prefer avoidance coping, and a preference for dysfunctional coping tracks with more severe positive and depressive symptoms and cognitive impairment.

Use safety measures when a client believes they must protect themselves against a specific person. Delusional thinking during the acute phase can tell the client to hurt others or self, so external controls may be needed. Protect yourself first: keep the door on your side, keep a clear escape route, call for help, and never try to handle it alone.

Keep staff assignments consistent. Stability, familiarity, and the same honest faces build trust with a suspicious client.

Refer to cognitive remediation therapy. It improves numerous cognitive functions with measurable brain imaging changes. It is time and labor intensive and works best tailored to each client.

Promote smoking cessation. Most clients with schizophrenia smoke, possibly to offset antipsychotic side effects or from boredom, peer pressure, or unemployment.

4. Promoting Effective Coping Strategies

Help the client build adaptive ways to manage symptoms and daily challenges: exercise, relaxation, supportive therapy or groups, a structured routine, problem-solving, and a strong support network.

Assess regularly for rising anxiety and hostility. Step in before the client loses control. Strange behaviors (water intoxication, mirror staring, stereotyped activity, hoarding, self-mutilation) and a disturbed sleep-wake cycle can predispose to anxiety and hostility.

Assess for causes of agitation or violence. Adverse childhood experiences (ACEs) are linked to more psychotic symptoms, greater cognitive deficits, worse treatment response, and more functional impairment. The Childhood Experience of Care and Abuse Questionnaire (CECA-Q) collects ACE data. Substance abuse is also tied to violence here.

Note indecision, dependence, and inability to manage ADLs. The client may need to lean on others temporarily. Early recognition helps them regain equilibrium.

Assess existing coping skills and inner strengths. Past successful skills can relieve tension now, though the condition limits some options, for example loud music is a poor choice for a client with auditory hallucinations.

Explain what you are about to do before you do it. This prevents the client from misreading your intent as hostile. Clients with an ACE history may be more sensitized to stress and threat.

Use a nonjudgmental, respectful, neutral approach. Neutral content and a respectful approach give a suspicious client less to misinterpret. "I know the voices are real to you, I do not hear them" is honest and helps the client gain control.

Use clear, simple language. Concrete or literal thinking means abstract phrases and cliches get misread. If you are lost, say, "I am not sure what you mean. Can you explain it again?"

Defuse angry verbal attacks with a nondefensive stance. Defensiveness escalates anger on both sides. A neutral, nonjudgmental attitude makes room to explore feelings.

Set limits in a calm, matter-of-fact way. For example, "Threatening remarks are not acceptable. We can talk about better ways to handle your feelings." Clear rules and consequences help everyone and depend on the client's situation.

Be honest and consistent about expectations and rules. Suspicious clients spot dishonesty fast, and you must be willing to follow through on consequences for trust to grow.

Keep stimuli low and the environment nonthreatening, and avoid groups. Noisy settings feel threatening. Know the client's triggers and recognize agitation, anxiety, or stress early.

Account for ideas of reference. Do not laugh, whisper, or talk quietly within the client's sight but out of earshot, since a suspicious client will assume they are the target. The client may also believe their food is poisoned, so offer sealed food they can open themselves or let them choose between options for a sense of control.

Start with solitary, noncompetitive activities that take concentration, then move to a game with one or more clients that requires focus (chess, checkers, bridge, rummy). Concentration minimizes paranoid rumination, and socialization group therapy improves socialization ability.

Provide verbal and physical limits as hostility escalates: "We cannot allow you to verbally attack someone here. If you cannot control yourself, we are here to help." Verbal limits often help the client regain control. Call for help when needed, keep the door on your side with a clear escape route, and stay aware of your surroundings.

Encourage family to provide emotional support. Parental support builds more adaptive coping. Early parental loss can disrupt coping development and is linked to more substance use, behavioral disengagement, and emotional eating.

Establish a therapeutic nurse-client relationship. Within it the client can voice helplessness and powerlessness and explore changes that could improve their situation. Trust built early creates comfort and a therapeutic environment.

5. Initiating Patient Education and Health Teachings

Teach the client and family about the illness, its symptoms, and treatment, plus coping skills, medication management, and stress reduction. Knowledge lets patients participate in their own care and make informed decisions.

Assess the family's current knowledge of the disease and medications. Families may carry misconceptions or none at all. Poor knowledge about mental illness is itself part of stigma and is linked to stigmatizing attitudes.

Assess the family's ability to cope (loss, caregiver burden, support needs). The family unit must be stabilized. Objective burdens are tangible, such as finances; subjective burdens are how caregivers perceive their situation.

Assess role expectations among family members and open them up for discussion. Each person sees the situation differently. Unmet caregiver expectations are a major source of mental burden, and schizophrenia often makes family roles hard to fulfill.

Note cultural and religious beliefs. These shape how the client and family react to and adjust to diagnosis, treatment, and outcomes. Caregiving roles and stigma exposure often differ by gender within a family.

Teach the family about pharmacologic therapy in clear, simple terms: dose, duration, indication, side effects, and toxic effects, with written information for the client and family. Understanding the disease and treatment increases family support and adherence, including the importance of abstinence from alcohol and other drugs.

Teach the client and family the warning signs of relapse. Early recognition of decompensation (insomnia, increased irritability) lets them seek immediate care and helps everyone cope better.

Teach disease and treatment information at the family's level. Because other illnesses are common in schizophrenia, cover healthy lifestyle, regular healthcare, and counseling on sexuality, pregnancy, and sexually transmitted diseases.

Give the family room to discuss feelings about their ill family member and name their immediate concerns. You intervene best when you understand the family's experience. Caregivers commonly report worry, tension, frustration, anger, and shame.

Provide community resources for after discharge: day hospitals, support groups, organizations, psychoeducational programs, and community respite centers. The family can be referred to the National Alliance on Mental Illness (NAMI). These resources help the family:

• Access caring, resources, and support
• Develop family skills
• Improve quality of life for all members
• Reduce isolation

Listen for expressions of helplessness and hopelessness. Relief at the client's recovery is often replaced by grief and anger at the loss of the pre-illness person, and prolonged, these feelings can become depression.

Provide information about family intervention. Family intervention is an evidence-based practice that reduces relapse and rehospitalization. High expressed emotion (hostile overinvolvement and intrusiveness) leads to more frequent relapse, and family therapy can improve adherence.

Identify and encourage previously successful coping behaviors. Most people already have effective coping skills to draw on. Build spaces where caregivers can speak openly about stigma and their own needs, and facilitate respite, peer support, and access to healthcare for them.

6. Administer Medications and Provide Pharmacologic Support

Schizophrenia medications include typical and atypical antipsychotics, which modulate dopamine and serotonin receptors to manage positive and negative symptoms. Choice depends on individual factors and symptom severity. Clozapine is reserved for treatment-resistant cases, and mood stabilizers or benzodiazepines may be added for specific symptoms or comorbidities.

Typical Antipsychotics

• Chlorpromazine. Blocks dopamine receptors to reduce hallucinations and delusions. May cause sedation and movement disorders.
• Haloperidol. A dopamine antagonist effective against positive symptoms, with lower sedation risk but higher potential for movement-related side effects.
• Fluphenazine. Blocks dopamine receptors, given orally or by injection. May cause sedation, movement disorders, and sexual dysfunction.

Atypical Antipsychotics

• Risperidone. Targets dopamine and serotonin receptors, effective for positive and negative symptoms. Available oral and long-acting injectable.
• Olanzapine. Acts on dopamine and serotonin receptors for positive and negative symptoms. Oral and injectable; associated with weight gain and metabolic side effects.
• Quetiapine. A dopamine and serotonin antagonist for positive and negative symptoms. Generally well tolerated but can cause sedation and weight gain.
• Aripiprazole. A partial dopamine agonist that balances dopamine activity, effective for positive symptoms with lower movement-related side effect risk.
• Ziprasidone. Targets dopamine and serotonin receptors for positive and negative symptoms. Lower weight gain risk but can alter heart rhythm.

Clozapine

Clozapine is sometimes used for clients who are violent. It is the oldest atypical antipsychotic and probably the most effective: roughly one-third of clients who failed conventional agents do better on it, and violence, hostility, and suicidality may decrease with its use.

Mood Stabilizers (e.g., lithium carbonate, valproate)

Sometimes combined with antipsychotics to manage and stabilize mood fluctuations.